Guide to Hand Tremors and Hand Shivering Problem 

Hand tremors can severely impact a person's daily life, making simple tasks difficult and reducing overall quality of life. This blog provides a detailed overview of the causes and types of hand tremors, helping you gain a deeper insight into this condition. What makes this blog especially valuable is our focus on a wide range of exercises specifically designed to help reduce hand shaking. By incorporating these exercises into your daily routine, you can improve dexterity, stability, and independence. At Physiotattva, we are committed to empowering you with practical solutions to manage hand tremors and regain control. 

What are Hand Tremors?

Tremors are involuntary rhythmic movements occurring in any part of the body. While slight tremors, known as physiological tremors, are common and often harmless, more pronounced or frequent tremors can indicate underlying medical conditions. The intensity and frequency of the trembling can provide valuable insights into the severity of the condition. Understanding the nature of tremors is crucial in recognising potential health concerns and seeking appropriate medical evaluation and intervention when necessary.

What Are the Types of Tremor?

Tremors are classified based on when and how they occur. The two primary categories are rest tremor and action tremor:

Rest Tremor: Appears when muscles are at rest and relaxed, commonly seen in Parkinson’s disease.

Action Tremor: Occurs during voluntary muscle movements. Action tremors are further divided into subtypes:

• Postural Tremor: Triggered when maintaining a position against gravity, such as holding outstretched arms.
• Kinetic Tremor: Arises during voluntary movements, like moving the wrists or blinking.
• Intention Tremor: Increases as a person moves closer to a target, such as touching their nose.
• Task-Specific Tremor: Occurs during particular activities like handwriting or speaking.
• Isometric Tremor: Happens during a voluntary muscle contraction without visible movement, such as holding a heavy object.

Common Tremor Syndromes

Several tremor syndromes are defined by their pattern and underlying cause:

1. Essential Tremor: The most common movement disorder, mainly affecting the hands during action. It may also involve the head, voice, or legs. Essential tremor often begins between 40 and 50, and about 50–70% of cases are inherited. The exact cause is unclear but involves mild cerebellar degeneration.
2. Dystonic Tremor: Associated with dystonia, a movement disorder causing involuntary muscle contractions and abnormal postures. It commonly affects the neck, voice, arms, or legs and may improve with complete relaxation or sensory tricks like touching the affected area.
3. Cerebellar Tremor: A slow, high-amplitude tremor seen at the end of purposeful movements. It results from cerebellar damage due to stroke, tumour, injury, inherited disorders, or chronic alcohol misuse.
4. Functional Tremor: Also called psychogenic tremor, it can mimic any tremor type. Symptoms often begin abruptly, vary greatly, and improve with distraction.
5. Enhanced Physiologic Tremor: A fine, small-amplitude tremor that usually results from temporary conditions like medication effects, alcohol withdrawal, overactive thyroid, or low blood sugar. It is reversible once the cause is treated.
6. Parkinsonian Tremor: A characteristic tremor of Parkinson’s disease, often appearing at rest, typically starting in one limb. It may resemble "pill-rolling" between the thumb and forefinger and can extend to the chin, lips, face, or legs. Stress and strong emotions often worsen it.
7. Orthostatic Tremor: A rare condition involving rapid muscle contractions in the legs when standing. It usually stops when sitting or walking, but can cause unsteadiness. The tremor is often too fast to see but can be detected by touch or a stethoscope. Its cause remains unknown.

What Causes Hand Tremors

Understanding the underlying causes of hand tremors is crucial in developing an effective management approach. We will delve into various factors contributing to hand tremors, such as neurological conditions, essential tremors, Parkinson's disease, and medication side effects. Tremors can be normal or a result of neurological disorders, other health problems, or medication use. Below are some frequently encountered causes:

Enhanced Physiological Tremor

This is the most commonly observed and easily recognizable type of tremor that typically manifests in the hands. This can be caused by:

• Anxiety
• Stress
• Fatigue
• Lack of sleep

This type of tremor usually does not need medical intervention.

Neurological Conditions

Disruption in neurological functioning also results in hand tremors. Various factors can contribute to this, including:

• Multiple sclerosis (MS): This disease is degenerative and affects the central nervous system, causing a delay in relaying messages by nerves. This can result in hand tremors.

• Traumatic Brain Injury: Injuries to the brain can disrupt neurological functioning, impacting how motor responses operate in the body. Injuries specific to some areas of the brain can cause tremors.

• Stroke: After a stroke, severe hand tremors can occur based on the affected area of the brain, significantly impacting daily tasks and quality of life. Stroke rehabilitation plays a crucial role in managing tremors through targeted interventions, exercises, and strategies, promoting motor function recovery and enhancing functional independence.

• Dystonia: It is a movement disorder characterised by involuntary muscle contractions causing repetitive movements and abnormal postures, resulting in repetitive movements and abnormal postures. It is linked to tremors, which can be jerky and irregular, regular and wave-like, or mixed, with hand tremors commonly seen in mixed-type dystonia.

Parkinson's Disease Tremor

Parkinson's disease leads to the degeneration of nerve cells in crucial areas of the brain responsible for motor responses. This lack of nerve cells results in varied intensities of tremors at different emotional periods.

Essential tremors

Essential tremor is a neurological disorder that primarily causes rhythmic shaking of the hands, although the head, trunk, and voice can also be affected. Hand tremors are usually the most noticeable symptom. While the exact cause of essential tremor remains unclear, it is often hereditary, with the condition being passed down from parent to child in many cases.

Essential tremor is sometimes mistaken for other types of tremors, making an accurate diagnosis crucial. The shaking typically worsens during voluntary movements rather than at rest, and symptoms can become progressively disabling over time.  Outlined below are several key distinctions between the two-

Timing of Tremor

While essential tremor occurs when you use your hands, Parkinson's tremors will happen when your side rests your hands.

Associated conditions

Essential tremor doesn't cause significant health problems, while Parkinson's results in slow movement, stooped postures, and unusual gait.

Diagnosing the Underlying Cause of Shaky Hands

Diagnosing shaky hands requires a detailed evaluation by a healthcare professional to identify the root cause and determine the best course of treatment. The diagnostic process typically involves the following steps:

• Medical History and Physical Examination: The doctor will collect a comprehensive medical history, focusing on when the symptoms began, how often they occur, and any triggering factors. A physical examination is conducted to assess general health and detect neurological signs.
• Neurological Examination: A focused neurological assessment evaluates the type and characteristics of the tremor through tasks like arm extension, nose-touching, and other coordination tests.
• Medication and Substance Review: The healthcare provider will review all current medications and ask about caffeine, stimulant, or substance use, as these can sometimes cause or worsen tremors.
• Blood Tests: Laboratory tests may be ordered to check for underlying conditions such as thyroid dysfunction or metabolic imbalances that might contribute to tremors.
• Imaging Studies: MRI or CT scans may be recommended to rule out structural abnormalities in the brain or nervous system.
• Electrophysiological Testing: Procedures like electromyography (EMG) and nerve conduction studies measure muscle and nerve activity to uncover possible neuromuscular issues.
• Specialised Neurological Testing: In certain cases, specific tests like a dopamine transporter (DaT) scan are performed, particularly if Parkinson’s disease is suspected.
• Psychological Evaluation: If a psychogenic tremor is considered, psychological assessments may be conducted to explore emotional or psychological factors.

After identifying the cause, the healthcare provider will recommend appropriate treatment options and create a tailored management plan to address the underlying condition.

Hand Tremor Treatment Options

Effective management of hand tremors depends on the underlying cause, severity of symptoms, and individual needs. Treatment focuses on reducing tremor intensity, improving hand function, and enhancing overall quality of life. Options range from medications and therapy to surgical procedures for severe cases.

Medications

Treatment often begins with medication. Beta-blockers like propranolol and anticonvulsants such as primidone are commonly prescribed for essential tremors. Parkinson’s-related tremors may be managed with levodopa, while clonazepam can help when anxiety worsens symptoms.

Lifestyle Changes and Therapy

Physical and occupational therapy can improve muscle strength and control. Managing stress through relaxation techniques and reducing caffeine and alcohol intake can also help reduce the severity of hand tremors.

Surgical Treatments

Severe tremors that do not respond to medications may be treated with Deep Brain Stimulation (DBS) or focused ultrasound thalamotomy, both of which target specific brain areas responsible for tremor control.

Botox Injections

Botulinum toxin injections may be recommended for certain types of tremors. These injections work by weakening overactive muscles, helping to reduce the frequency and intensity of the tremors.

Hand and wrist exercises for Hand Tremors

Here are some easy-to-do hand and wrist exercises that can help you reduce hand tremors

• Squeezing a stress ball for two to 15 seconds and repeating this around 15 times on each hand daily.
• Rotating the wrist in slow, circular motions at regular intervals during the day will help prevent synovial fluid from building up, reducing tremors.
• Relaxation techniques such as meditation, gentle yoga, and engaging in mindful activities can help reduce stress and positively impact lowering tremors.

Medication for tremors, prescribed by doctors after diagnosis, can also reduce the intensity of hand tremors.

Hand Tremors Exercises For Parkinson's Disease

The following activities are some common hand exercises for Parkinson's.

• Squeezing a soft ball by keeping it in the middle of your palm, grasping it tightly for ten seconds, and repeating it regularly.
• Clenching and unclenching your fist several times at regular intervals during the day.
• Tapping your index finger with the upper thumb finger at regular intervals during the day.
• Bend your fingers down and try to touch the bottom of your palm.

Physiotherapy For Hand Tremor

Physiotherapy can help reduce the intensity of the tremors. It can provide relief with proper care and an exercise regime by trained physiotherapists. Some of them are:

Shoulder Shrugs

This will help increase the frequency of activity between the brain and the arms. The exercise boosts synaptic chain interaction, increasing muscle movement that can help reduce tremors.

Bicep curls

Bicep curls, with the proper guidance by the physiotherapist, can help build muscle in the arm, which can help increase the stability of hand movements, reducing tremors.

Hydrotherapy 

Hydrotherapy can also be a helpful method to deal with tremors and for people with less mobility. Water's buoyancy facilitates gentle movements that gradually enhance over time.

When to See a Doctor for Hand Tremors

If you notice:

• Tremors worsening over time
• Loss of hand functionality
• Tremors occurring alongside other neurological symptoms
• No improvement despite lifestyle changes

You must consult a healthcare professional to evaluate the need for hand tremor treatment.

Get Expert Help for Hand Tremors at Physiotattva 

Regain control over hand tremors, incorporate targeted exercises into your routine to improve stability and quality of life. Seek personalised guidance from our skilled professionals. Start taking actionable steps today with Physiotattva and reclaim your independence!

At Physiotattva physiotherapy clinics in Bangalore and Hyderabad, you receive personalised care tailored to your specific needs, ensuring effective results and comfort throughout your journey to recovery. 

Don’t wait to start your recovery! Get in touch with Physiotattva for more details! Contact us at +91 89510 47001.

Frequently Asked Questions

How do you fix hand tremors?

Hand tremors can be caused by conditions like Parkinson's, Multiple Sclerosis, or brain injury. Our experts recommend practicing hand and wrist exercises to cope with this condition. Further, physiotherapy offers hydrotherapy, tissue mobilization exercises, and acupuncture to treat hand tremors effectively. 

What is the best exercise for tremors?

Tremors are involuntary and rhythmic muscle contractions that may result from stress or severe medical conditions. Experts recommend hand and wrist exercises to cope with these tremors. The best exercises for the condition include rotating the wrist, shoulder shrugs, bicep curls, and yoga. 

Can shaky hands be fixed?

While there is no permanent cure, shaky hands or tremors can be managed by hand and wrist exercises, medication, relaxation techniques, hydrotherapy, and general lifestyle changes. 

What vitamin is good for hand tremors?

Research shows that Vitamin B12, B-6, or B-1 is essential in coping with hand tremors. These vitamins can be acquired through supplements, medication, or everyday foods (eggs, milk, cereals, animal products).

How do you stop the hands from shaking?

Try relaxation techniques, avoid triggers like caffeine, perform hand exercises, consider medication adjustments, utilise assistive devices, and manage stress to minimize hand shaking. Consult a healthcare professional for personalized advice.